George W Brown, the pre-eminent medical sociologist whose research brought social and environmental factors into the study of mental illness, has died aged 95.
Across a six-decade academic career, Brown examined how people experienced mental illness beyond the hospital setting. His work explored the role of families, stigma, stressful events and difficult living circumstances in recovery and relapse.
Changing the focus beyond hospital walls
Brown joined the Social Psychiatry Research Unit in Camberwell, south London, in 1956 after being recommended for a position there. Established in 1948, the unit studied mental illness through social and environmental factors, including how patients and families coped after hospital discharge.
Brown observed that patients discharged to live with parents and other family members were readmitted to hospital more often than those discharged to hostels or to live with people who were not relatives. His research also found that stigma and difficulties experienced by close family members could adversely affect people with schizophrenia and make relapse more likely.
He introduced the term “expressed emotion”, or EE, to describe the emotional atmosphere within a family or household. Brown used high EE for an environment he characterised as cold, critical and hostile toward a person with schizophrenia, and found that relapse was more likely in those circumstances.
In 1966, Brown and psychiatrist Michael Rutter developed the Camberwell Family Interview. The interview was designed to measure different types of expressed emotion and examine family-life dynamics.
Colleagues remembered Brown as a skilled and empathetic interviewer. He was said to build rapport, allowing people to speak freely while ensuring that important topics were covered.
Research into depression and women’s lives
Brown moved to the Social Research Unit at Bedford College, University of London, in 1967. Bedford College is now part of Royal Holloway. He became professor of sociology and the unit’s joint director in 1973, and established the UK’s first master’s degree course in medical sociology.
From 1968, Brown and Tirril Harris interviewed women in Camberwell for two major studies of depression. Their research included 114 women diagnosed with depression and 344 women in a control group. The article states that women were selected because they are twice as likely to become depressed as men.
Brown and Harris published Social Origins of Depression: A Study of Psychiatric Disorder in Women in 1978. They developed the “life events and difficulties schedule” to assess stressful events and chronic difficulties.
Their work found a link between clinical depression and women’s experiences, identifying four factors associated with vulnerability: the absence of a close relationship, losing one’s mother before age 11, caring for three or more children under 14, and not having paid work outside the home. These factors were described as increasing vulnerability, not as inevitable causes of depression.
The book and related papers became widely cited and were described as foundational in social psychiatry. Brown and Harris later published Life Events and Illness in 1989.
A route into academic life
Brown was born in Notting Hill, London, and grew up in a close-knit family. He was evacuated to Wales during the second world war but returned to London because he was homesick. As a child, he played with friends and searched for scrap iron in bomb-damaged rubble.
He passed the 11-plus examination and attended Kilburn grammar school, leaving at 16 to earn money. While working for a heating and ventilation company, he heard a radio programme about the Egyptian pyramids, contacted its author and began teaching himself Latin.
After national service in the air force, Brown entered University College London in 1951 to study Egyptology. He later switched to anthropology and graduated in 1954. His comparative studies included work in the Outer Hebrides, Spain and Zimbabwe.
Personal experiences also shaped his awareness of silence and shame around suicide. The suicide of a cousin’s wife and his twin sister Betty’s suicide attempt affected him, and contributed to his understanding of suicide as a taboo subject in families.
Later years and legacy
Brown retired from Bedford College in 1999 but continued researching into his 80s. He remained an honorary research fellow at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London until 2015.
He was appointed OBE in 1995. Away from his academic work, he enjoyed spy thrillers, read voraciously and regarded Charles Darwin as his hero. He also had a wide knowledge of art and music.
Brown married Gillian Hole in 1954 and later married Sieja Sandberg in 1978; both marriages ended in divorce. In 1990 he married Elizabeth Davies, described as a professor of cancer and public health at King’s College London.
He is survived by Elizabeth and their children William and Frances, by James and Joanna from his first marriage, by Catharina from his second marriage, and by five grandchildren.
AI tools were used to assist with the preparation of this article under our editorial standards.
Leave a Reply